Motion control insole with muscle strengthening component

ABSTRACT

The present invention relates to an insole, midsole or unified outsole-midsole-insole device for use with an article of footwear, displaying significant improvement over conventional similar insole type products through its ability to offer to the wearer an adjustable biofeedback component for the rehabilitation and strengthening of the foot&#39;s muscles, as well as an adjustable motion control component for the purpose of controlling the pronation and arch deflection of the human foot during gait. Through this means wearers of the device gradually strengthen their foot while simultaneously decreasing their dependence on secondary motion control structures.

TECHNICAL FIELD

The present invention relates to a device to be integrated into anarticle of footwear, to interact with the plantar surface of the foot,and to address gait related issues surrounding weakened foot structureand faulty gait biomechanics.

BACKGROUND ART

There is a significant quantity of evidence from the medical andbiomechanical professions presenting a strong correlation between faultyfoot function and associated foot, leg and lower back disorders. Thecorrelation is such that it has been proposed, and accordinglysupported, that non-ideal foot function can be a determining factor fornumerous gait related pathologies. The ideal functions of the foot havebeen falsely categorized by academics studying the trends and datacollected during the analysis of gait biomechanics, kinetics andkinematics. The collected data, and observations made, have been frompopulations whom have traditionally worn shoes. The repeated exposure tothe bracing environments, which shoes are, has been shown to havedetrimental effects on the foot and most notably the foot'smusculo-skeletal structure. Normal, or average, values have been takenfrom these populations and have been used by those skilled in the art ofbiomechanics, podiatry and related fields, as descriptors of ideal. Thisapproach however is faulty in that the mean or average, taken frompopulations, reported to have as much as 85% of their total, displayingsymptoms related to less than ideal mechanics, will statisticallygenerate values for the norm that are well below ideal. As such theindustry defined “normal” is far less than “ideal”.

Numerous inventions have been disclosed to address the excess pronationand inadequate re-supination that is characteristic of our less thanideal gait. However these are based on techniques and designs thatencourage a bracing or supportive environment for the foot. Theseinventions disclose the use of a wide range of materials and methods offabrication, however the vast majority of these attempt to promotenormal gait biomechanics through the bracing of the foot. U.S. Pat. No.4,232,457 of Mosher, discloses a typical and accepted support devicemade from rigid or semi-rigid materials and primarily focuses on bracingthe medial arch of the foot. In U.S. Pat. No. 5,058,585 Kendalldiscloses a modified horseshoe shaped structure intended to support andguide the foot through a bracing of the medial arch. Inventions such asthese will ultimately lead to a weakening of the foot's supportingmusculoskeletal structure, potentially predisposing the foot to injury,and potentially requiring the use of a stronger and more supportivebracing device as the structure continues to weaken. It is well acceptednow, in medicine, that bracing of the musculoskeletal system promotes aweakening of the supporting structures, and bracing is not the firstchoice when rehabilitating.

In what has been proposed to be a more holistic and ideal approach,Burke, in U.S. Pat. No. 5,404,659, as well as Gardiner, in U.S. Pat.No's. 6,301,807 and 6,732,457, disclose devices proposed to elicitmuscle contractions through the introduction of a proprioceptivestimulus to the plantar aspect of the foot. It has been found, by theinventors, that when using these devices they have considerablelimitations and fall short of providing the foot with the support andguidance required to achieve ideal gait biomechanics during the initialphases of use and rehabilitation, and in particular a failure to supportthe medial aspect of the foot and to guide the foot during propulsion.Although said devices may provide some aspect of stimuli they areincapable of providing quick effective alteration of the users gaitmechanics. A device capable of providing both a progressiverehabilitative aspect and a regressive support aspect would prove to bean effective treatment and improvement over current products. In thismanner a device which would continue to support the foot until it isstrong enough to achieve ideal mechanics on its own is desirable.

The invention disclosed by Burke and those of Gardiner are most notablycharacterized by a dominant apex located in the region of theintersection of the cuboid, navicular and lateral cuneiform. It has beendiscovered by the inventors, that the plantar pressures generated duringnormal walking, jogging and running, result in a lateral to medialshifting of the devices, as described by Burke and by Gardiner, insideof the users' footwear. Through the inspection of wear patterns onpreviously used devices, such as those described by Burke and those ofGardiner, it has been found by the inventors, that the desired apexregion that the foot migrates to, is larger and more medial to thatdisclosed by Burke and disclosed by Gardiner. In fact wear patternsreveal that the highest point does not truly take the form of an apexbut a plateau which also serves to reduce the localized pressure causedby the apex which has been found to on occasion cause excess discomfortrendering the device unusable. Although it may be advantageous topromote a domed anatomical structure as described by Burke and byGardiner, to allow for tri-planar motion, the shape of the domed likestructure formed by the foot's arch system is not replicated by theinventions of Burke and by those by Gardiner, and require a more plateaulike arrangement. Mitchell, in U.S. Pat. No. 5,388,351, does provide fora plateau, which however is too large with respect to the foot's plantarsurface area to allow any form of tri-planar motion and is thusundesirable. A device capable of encouraging a more limited tri-planarmotion, in particular regulating but not limiting the pronation, wouldbenefit users.

The inventions disclosed by Burke and by Gardiner fail in introducingprovisions which control excess pronation during the stance phase ofgait and faulty foot position at propulsion. The failure to addressthese concerns predisposes the users of these inventions to excessstrain on the foot's supporting muscles as the foot attempts to conformto the centrally located apex, while simultaneously inwardly rotating asthe foot naturally pronates during walking, running and such. An apex ofthe heights and at the location as disclosed in Gardiner's patents mayactually result in an increase in the rate of pronation during thestance phase of the gait cycle. This may as a result, predispose wearersto increased strain on the musculoskeletal system and potentiallyfurther discomfort and injury.

It is the intent of the present invention to introduce a device capableof promoting a strengthening of the musculoskeletal system, and inparticular those regions and organs related to the bones, muscles andconnective tissue necessary for ideal and effective gait, whilesimultaneously providing for the support and guidance required on thefoot's medial and anterior aspects for the purpose of reducing theexcess pronation which often accompanies a weakened foot structure. Thepresent invention discloses a specific raised area, engineered toreceive removable and replaceable inserts, designed and configured toachieve the desired functions of muscular rehabilitation of the foot'smuscles and the simultaneous control of harmful excess pronation duringwalking, running or such activities.

BRIEF SUMMARY OF THE INVENTION

The present invention discloses a device designed to interact with theplantar surface of the wearer's foot, most notably in the form of a shoeinsole, a shoe midsole, or similar. The present invention is mostdistinctively characterized by a dominant or primary area risingupwardly from the body of the device and so positioned to engage theplantar aspect of the foot in the region of the first ray and the commonarea of the adjoining region of the anterior most portion of the medialtubercle of the talus, the navicular, the 1^(st) cuneiform and themedial most aspect of the cuboid. This area of engagement with theplantar region of the foot generally is characterized by a triangularshape and assumes a plateau region with respect to the balance of theprimary raised area.

The general shape of the primary raised area is such that on itsposterior most aspect there are inherent design characteristics, mostnotably in the form of a varus type wedge capable of reducing the excesseversion of the calcaneus if the foot is excessively pronating.

The general shape of the primary raised area also possesses a definingridge generally aligned and positioned parallel with the long axis ofthe 2nd ray for the purpose of encouraging the formation of a metatarsalarch, and encouraging the re-supination of the foot which is requiredfor efficient propulsion during ideal gait. The invention also disclosesaccommodations, or provisions, in the regions of both the 1^(st) and5^(th) metatarsals to further encourage efficient propulsion duringideal gait.

Most notable in the present invention are provisions within the raisedarea, in the form of receptacles, for the purpose of receivingcompressive inserts generally aligned with the first ray, for thepurpose of controlling medial arch deflection, and generally alignedwith the soft tissue area of the flexor digitorum brevis and flexorhallicus longus muscles, for the purpose of gradually introducing abiofeedback component to the foot's main supporting musculature. Throughtheir symbiotic application the invention is capable of encouraging astrengthening of the foot's supporting musculature while affording thewearer the ability to continue to support their arch system when needed.The wearer then may gradually reduce said support as the footstrengthens in response to the muscle strengthening insert.

DESCRIPTION OF THE DRAWINGS

FIG. 1 is a dorsal view of the present invention illustrating the size,shape and periphery dimension of the preferred embodiment relative tothe human skeletal foot. (Right foot shown). Wherein the perimeter ofsaid invention is depicted by a dotted line, the perimeter of theprimary raised area is defined by a dashed and dotted line, and theperimeter of the elevated plateau region is depicted by a dashed line.Also shown are key angular orientations, most notably the long axis ofthe 1^(st) metatarsal and the long axis of the 2nd metatarsal of thefoot.

FIG. 2 is a dorsal view of the present invention illustrating andlocalizing the key anatomical structures of significance to the presentinvention. Of significance are the 1^(st), 2^(nd) and 5^(th)metatarsals, the cuboid, the calcaneus, the talus, the navicular, andthe 3 cuneiforms.

FIG. 3 is a plantar view of the present invention illustrating thelocation of the elevated plateau region of the primary raised areaencompassing the pronation controlling insert and the muscle stimulatinginsert, relative to the muscular structures characteristic of the foot'splantar aspect. Notable are the flexor digitorum brevis and the flexorhallicus longus. (Left Foot Shown)

FIG. 4 is an approximation of a medial sagittal plane view of thepresent invention sectioned through D-D′ and relative to the right foot.

FIG. 5 is a plantar view of the primary raised area (Left foot shown) ofthe invention illustrating the general location of the openings toreceive the pronation controlling and the muscle stimulating inserts andthe general perimeter shape of the primary raised area, and referencepoints for the cross sectional drawings

FIG. 6 is a cross sectional drawing of the present invention throughSection A-A′.

FIG. 7 is a cross sectional drawing of the present invention throughSection B-B′.

FIG. 8 is a cross sectional drawing of the present invention throughSection C-C′.

FIG. 9 is a cross sectional drawing of the present invention throughSection D-D′.

FIG. 10 is a cross sectional drawing of the present invention throughSection E-E′.

FIG. 11 is an illustration showing the pronation controlling and themuscle stimulating inserts to be applied to the present invention as twoseparate devices.

FIG. 12 is an illustration showing the pronation controlling and themuscle stimulating inserts constructed so as they are integrated as aone unit device to be applied to the present invention.

FIG. 13 is a posterior view of the human foot and ankle (right footshown) illustrating the action of pronation (shown by a solid line witha directional arrow), and the location of the sub-talar axis (shown bythe dashed-dotted lines), and the effect on correcting rear foot angle(shown by the dashed lines) through the application of a medial heelwedge device.

FIG. 14 is a dorsal view illustrating the general peripheral shape ofthe invention and the primary raised area with a modified anterior mostarc and illustrating the general areas of the lateral and medialforefoot accommodations.

FIG. 15 is a dorsal view illustrating the elevated plateau area of thepresent invention and how it maybe interpreted as having a “triangular”shape or a “T” shape.

FIG. 16 shows the present invention with the pronation controllinginsert and the muscle stimulating insert applied to the presentinvention in a dorsal-to-plantar direction, as well as the presentinvention with the pronation controlling insert and the musclestimulating insert applied to the present invention in aplantar-to-dorsal direction.

FIG. 17 is a perspective view of the present invention showing a lowerinsole type body capable of receiving, upon it's dorsal surface, theprimary raised area which is manufactured as a separate unit.

FIG. 18 is a perspective view of the present invention showing an upperinsole type body capable of receiving, at it's plantar surface, theprimary raised area which is manufactured as a separate unit.

FIG. 19 is an arrangement of cross sectional designs of possibilitiesfor the openings and corresponding inserts and the potential geometriccharacteristics of the openings and inserts that enable the securefixation of the inserts into the openings.

DETAILED DESCRIPTION OF THE PRESENT INVENTION

The present invention provides for a device in the form of a shoe insoleor shoe midsole or integrated shoe outsole-midsole-insole unit 1,capable of providing a progressive catalyst for muscle stimulation,muscle strengthening and muscular adaptation while encouraging propertoe off position and controlling for excess pronation of the foot.

The present invention may be constructed of materials of a semi-pliableand compressible nature such that it is comfortable to the plantarsurface of the foot. The materials of choice may include, but are notlimited to, polyurethane and its derivatives, ethyl vinyl acetate andits derivatives, visco-elastic polymers, natural sponge rubbers and itsderivatives, and other materials displaying similar characteristics.

In particular the present invention discloses a primary raised area 4designed to engage the plantar surface of the human foot. Said primaryraised area 4 has a centrally highest region 3 forming an elevatedplateau 5 with a periphery generally in a triangular shape 20, or“T”-shape 21, positioned in the region of the anterior most portion ofthe medial tubercle of the talus 6, the navicular 7, the 1^(st)cuneiform 8 and the medial most aspect of the cuboid 9. Said triangularelevated plateau 5 has it's longest side 27 positioned to be align ablewith the medial most aspect of the foot, plantar to the region of themedial arch and running parallel with the long axis 11 of the 1^(st)metatarsal 10, and its opposite vertex 28 positioned in the region ofthe medial aspect of the navicular 7 and not extending laterally pastthe lateral most aspect of the 2nd metatarsal 12. Said primary raisedarea 4 has outwardly directing surfaces 13 tapering downwardly andoutwardly from the triangular elevated plateau 5 in all directions so asto terminate at, or merge with, the top layer of the invention 22 uponwhich the foot rests, at distances approximating the boundaries as setout by the outer boundaries 2 of the primary raised area 4. Said outerboundaries 2 extend medially such that they do not extend past aboundary defined by the position of the medial most aspect of thenavicular and extend in the anterior direction such that they do notextend past the distal two-thirds of the 2^(nd) metatarsal, and extendlaterally such that they do not extend past the lateral most aspect ofthe cuboid, and extend in the posterior direction such that they do notextend past the medial tubercle of the calcaneus.

In this manner said invention offers to the wearer a system providingfor pronation control through the long side 27 of the triangularelevated plateau 5 and the introduction of a muscle rehabilitatingproprioceptive stimulus in the vicinity of the vertex 28.

Said primary raised area 4 has a noticeable non-symmetric elongation 14of its posterior and medial region extending rearward and downward fromsaid triangular elevated plateau 5. Said elongation 14 risessimultaneously in an posterior-to-anterior and lateral-to-medialdirection so as to create a region of gradually increasing densityrelative to the corresponding region on the lateral aspect of saiddevice, in the region of the lateral tubercle 25 of the calcaneus, insuch a manner as to introduce an inclined plane or wedge 16 effect tothe medial and anterior aspect of the calcaneus 15 for the purpose ofreducing the eversion of the calcaneus 15 during the stance phase ofgait which is characteristic of excess pronation. Said wedge 16 sitsanterior of the medial tubercle 24 of the calcaneus and as such does notfunction as a pronation regulating wedge unless and until the footbegins to excessively pronate, typically during the mid-stance phase ofgait.

Said primary raised area 4 has noticeable accommodation areas 17, 18 inthe regions posterior to the sesamoids 23 and the head of the firstmetatarsal 10 on the medial boundary of the foot, and the regionposterior of the fifth metatarsal head 26 on the lateral boundary of thefoot. Said medial accommodation area 17 and said lateral accommodationarea 18 are positioned such that on a horizontal plane they lay inferiorto the balance of the primary raised area 4 of the insole or midsolesurface 22 engaging the plantar aspect of the foot. This feature may befurther accentuated through the elongation of the anterior most arc 19of said raised area 4. Said accommodations allow for the distal portionsof the first and fifth metatarsals to sit at a level significantlyinferior to the vertical position of the 2^(nd) metatarsal 12. Saidprimary raised area 4 having a noticeably defined ridge 36 originatingfrom said triangular elevated plateau 5 and running in a posterior toanterior direction generally parallel and dorsal to the ray of the2^(nd) metatarsal, and terminating where said ridge merges with the toplayer 22 in the region of the boundary 2. Said defined ridge 36, runninggenerally parallel and dorsal to the ray of the 2^(nd) metatarsal, maydeviate in either a lateral or medial direction such that the long axisof the ridge does not have an angular deviation 42 of greater than 12degrees. This variability allows for anatomical deviations, createdthrough genetic predisposition or by environmental influences causingfoot deformity such as bunions or hallux valgus, to be accommodated.

In another aspect of the present invention there are provisions suchthat the compression of the triangular elevated plateau 5 region, whichaccompanies walking, running and such, maybe altered through theinsertion of removable inserts 33. Said removable inserts may bedesigned and manufactured such that they are separate and independentinserts wherein one is a pronation controlling insert 34 and anotherinsert is a muscle stimulating insert 35. Said removable inserts 33 maytake the form of mechanical devices for example a coiled spring, fluidor hydraulic devices, or compressible materials, such that the medialaspect or long axis of the plateau 27 may display a differentcompressive characteristic than that of the lateral aspect or vertex 28.The variance in compressive characteristics maybe achieved through theadjustment of height and/or the adjustment of the compression propertiesof the inserts 33. In this manner users may have the ability to adjustthe variance between the desired pronation control provided for in themedial most aspect of the plateau 27 and the muscle simulation pressureprovided for in the lateral most aspect of the plateau at the vertex 28.As such these provisions allow the user, at their convenience, to adjustthe device to accommodate for differences in foot type, shoeflexibility, rate of musculoskeletal change, and needed pronationcontrol.

Said removable muscle stimulating inserts 35, necessary to provide theproprioceptive muscle stimulation, applied at the vertex 28 are locatedat a region to apply mild upward pressure to the medial aspect of theflexor digitorum brevis 31 and the flexor hallicus longus 32 locatedimmediately dorsal and medial to the flexor digitorum brevis 31. Throughthe introduction of this pressure proprioceptive responses in the foot'smusculature are initiated and result in the creation of musclecontractions and thus function as an exercise component strengtheningthe foot. In another aspect of the present invention said removableinserts 33 maybe designed and manufactured as a one piece unit 41wherein an integrated pronation controlling insert 34 and an integratedmuscle stimulating insert 35 are mutually joined but may displaydifferent height, density or compression characteristics. In anotheraspect of the invention the top surface 22 in the region of the vertex28 and/or the top surface of the muscle stimulating insert 35 maybedesigned to incorporate pressure nodules 37 to provide additionalstimulation to the foot's plantar musculature.

In one aspect of the present invention there are provisions foradjusting the compressive characteristics of the inserts 33 which maytake the form of the fabrication of the inserts 33 of materials ofvarying heights and/or densities and/or compression properties.Preferred materials for the fabrication of the inserts 33 include, butare not limited to, foams such as polyurethane or its derivatives, ethylvinyl acetate or its derivatives, foam sponge rubber or its derivatives,and these maybe molded through compression or injection means or maybedie cut from sheet stock. The inserts 33 may also be manufactured ofvisco elastic materials such as thermo plastic rubber and itsderivatives, silicon and its derivatives and thermo plastic urethane andits derivatives, and maybe manufactured through such means as poring orinjection but are not limited to these means. The adjustment provisionsmay also be achieved through the insertion or application of differentsubstances displaying varying compression properties, or the insertionor applicable of mechanical devices, most notably springs, or gas orfluid filled bladders.

In yet another aspect of the invention there are provided openings orreceptacles to receive said inserts 33. Correspondingly so there is amedial most opening 29 align able to the desired position of thepronation controlling insert 34 and the long side 27 of the triangularelevated plateau 5 running parallel with the long axis 11 of the firstmetatarsal 10, and there is a lateral most opening 30 align able to thedesired position of the muscle stimulating insert 35 and the vertex 28of the triangular elevated plateau 5.

Said openings maybe designed such that the inserts 33 maybe securedwithin the openings by friction most notably achieved through theinserts 33 having their outer diameter a fixed percentage larger thanthe inside dimensions of the respective openings 29 and 30, wherein saidfixed percentage is derived from the co-efficient of friction realizedby the interaction of the material of manufacture of the inserts 33 andof the shoe insole or shoe midsole or integrated shoeoutsole-midsole-insole unit 1 material of manufacture. Said inserts 33may also be secured within said openings 29 and 30 through the useadhesives, hook and loop type fastening devices, a detent relationshipbetween the opening and the inserts 33, a corresponding design where theentrance end of the opening is a smaller diameter than the distal end ofthe opening and said inserts are designed to match, or similar designconfigurations or material selections that ensure the security of theinserts 33 within the openings 29 and 30.

The present invention may also be constructed in a manner wherein theshoe insole or shoe midsole or integrated shoe outsole-midsole-insoleunit 1 is constructed such that there are two or more structures andthere is a lower layer 38, constructed in a similar manner and ofsimilar materials as traditional footwear insoles and a primary raisedarea 4, wherein the primary raised area 4 is a separate unit 39 withprovisions capable of accepting the pronation controlling insert 34 andthe muscle stimulating insert 35. The separate unit 39 is applied to thedorsal surface of the lower layer 38 and maybe attached or adhered tothe lower layer 38 by means of insertion into a receptacle, throughadhesion by adhesive substances, through the application of hoop andloop type fastening materials, most notably Velcro™ type materials,through the use of matching male and female protrusions and matchingreceptacles as in a detent arrangement, or maybe attached throughsimilar attachment means and devices as described. The present inventionmay also be constructed such that the there is an upper layer 40 withprovisions capable of receiving the separate unit 39 as it is applied tothe plantar surface of the upper layer 40, and said separate unit 39 hasprovisions capable of accepting the pronation controlling insert 34 andthe muscle stimulating insert 35.

1) An insole or midsole or integrated unit sole for use with an articleof footwear which has a characteristic raised area wherein said raisedarea sits plantar to the foot and rising upwardly from the invention, tointerface with the plantar aspect of the foot, and wherein; said raisedarea has a highest portion taking the form of a generally triangularplateau positioned in the region of the planter aspect of the anteriormost portion of the medial tubercle of the talus, the navicular, the1^(st) cuneiform and the medial most aspect of the cuboid and wherein;said raised area has two or more openings designed to receive insertsand the openings are arranged such that the medial most opening andcorresponding insert is positioned plantar to the foot and in the regionof the posterior most aspect of the 1^(st) metatarsal, the navicular,and the anterior most aspect of the talus and the lateral most openingand corresponding insert is positioned plantar to the foot and in theregion of the lateral portion of the navicular interfacing in the regionof the muscle belly of the digitorum brevis and the flexor hallicuslongus muscles. 2) A device as disclosed in claim 1 wherein; saidplateau sits at a height which is not less than 2.5% of the total footlength and not greater than 7.5% of the total foot. 3) A device asdisclosed in claim 1 wherein; said raised area has outwardly directingsurfaces tapering downwardly and outwardly from the triangular plateauin all directions so as to terminate as they merge with the top layer ofthe invention and said surfaces extend medially such that they do notextend past a boundary defined by the position of the medial most aspectof the navicular, and extend in the anterior direction such that they donot extend past the distal two-thirds of the 2^(nd) metatarsal, andextend laterally such that they do not extend past the lateral mostaspect of the cuboid, and extend in the posterior direction such thatthey do not extend past the medial tubercle of the calcaneus. 4) Adevice as disclosed in claim 1 wherein; the triangular plateau has it'slongest side positioned to be align able with the medial most aspect ofthe foot, plantar to the region of the medial arch and running parallelwith the long axis of the 1^(st) metatarsal and wherein; the triangularplateau has its vertex positioned in the region of the medial aspect ofthe navicular and not extending laterally past the lateral most aspectof the 2nd metatarsal. 5) A device as disclosed in claim 1 wherein; saidraised area has a characteristic ridge extending from the triangularplateau forward in the anterior direction, align able and parallel tothe 2^(nd) metatarsal of the foot and aligned such that said ridge doesnot deviate in the medial or lateral direction more than 12 degrees fromthe centerline of the 2^(nd) metatarsal. 6) A device as disclosed inclaim 1 wherein; the raised area has a noticeable non-symmetricelongation of its posterior and medial region extending rearward anddownward from said triangular plateau. Said elongation rises in anposterior-to-anterior and lateral-to-medial direction so as to create aregion of gradually increasing density relative to the correspondingregion on the lateral aspect of said device, in the region of thelateral tubercle of the calcaneus, in such a manner as to introduce aninclined plane or wedge effect to the medial and anterior aspect of thecalcaneus for the purpose of reducing the eversion of the calcaneusduring the weight bearing phase of gait which is characteristic ofexcess pronation and; 7) A device as disclosed in claim 1 wherein; saidinserts to be applied to said openings are of varying compressiveproperties enabling varying deflection and support to the medial andlateral aspects of said triangular plateau. 8) A device as disclosed inclaim 1 wherein; said raised area has noticeable accommodation areas inthe regions posterior to the sesamoids and the head of the firstmetatarsal on the medial boundary of the foot, and the region posteriorof the fifth metatarsal head on the lateral boundary of the foot. Saidmedial accommodation areas and said lateral accommodation area arepositioned such that on a horizontal plane they lay inferior to thebalance of the raised area of the insole or midsole surface engaging theplantar aspect of the foot. 9) An insole or midsole or integrated unitsole for use with an article of footwear which has a characteristicraised area wherein said raised area sits plantar to the foot and risingupwardly from the invention, to interface with the plantar aspect of thefoot, and wherein; said raised area has a highest portion taking theform of a generally triangular plateau having it's longest sidepositioned to be align able with the medial most aspect of the foot,plantar to the region of the medial arch and running parallel with thelong axis of the 1^(st) metatarsal and having its vertex positioned inthe region of the medial aspect of the navicular and not extendinglaterally past the lateral most aspect of the 2nd metatarsal, andwherein; said raised area has a characteristic ridge extending from thetriangular plateau forward in the anterior direction, align able andparallel to the 2^(nd) metatarsal of the foot and aligned such that saidridge does not deviate in the medial or lateral direction more than 12degrees from the centerline of the 2^(nd) metatarsal. 10) A device asdisclosed in claim 9 wherein: said triangular plateau sits at a heightwhich is not less than 2.5% of the total foot length and not greaterthan 7.5% of the total foot. 11). A device as disclosed in claim 9wherein; the triangular plateau has it's longest side positioned to bealign able with the medial most aspect of the foot, plantar to theregion of the medial arch and running parallel with the long axis of the1^(st) metatarsal and wherein; the triangular plateau has its vertexpositioned in the region of the medial aspect of the navicular and notextending laterally past the lateral most aspect of the 2nd metatarsal.12) A device as disclosed in claim 9 wherein: the raised area has anoticeable non-symmetric elongation of its posterior and medial regionextending rearward and downward from said triangular plateau. Saidelongation rises in an posterior-to-anterior and lateral-to-medialdirection so as to create a region of gradually increasing densityrelative to the corresponding region on the lateral aspect of saiddevice, in the region of the lateral tubercle of the calcaneus, in sucha manner as to introduce an inclined plane or wedge effect to the medialand anterior aspect of the calcaneus for the purpose of reducing theeversion of the calcaneus during the weight bearing phase of gait whichis characteristic of excess pronation and; 13) A device as disclosed inclaim 9 wherein: said raised area has two or more openings designed toreceive inserts and the openings are arranged such that the medial mostopening and corresponding insert is positioned plantar to the foot andin the region of the posterior most aspect of the 1^(st) metatarsal, thenavicular, and the anterior most aspect of the talus and the lateralmost opening and corresponding insert is positioned plantar to the footand in the region of the lateral portion of the navicular interfacing inthe region of the muscle belly of the digitorum brevis and the flexorhallicus longus muscles, and; said inserts to be applied to saidopenings are of varying compressive properties enabling varyingdeflection and support to the medial and lateral aspects of saidtriangular plateau. 14). A device as disclosed in claim 9 wherein: saidraised area has noticeable accommodation areas in the regions posteriorto the sesamoids and the head of the first metatarsal on the medialboundary of the foot, and the region posterior of the fifth metatarsalhead on the lateral boundary of the foot. Said medial accommodationareas and said lateral accommodation area are positioned such that on ahorizontal plane they lay inferior to the balance of the raised area ofthe insole or midsole surface engaging the plantar aspect of the foot.15) An insole or midsole or integrated unit sole for use with an articleof footwear which has a characteristic raised area wherein said raisedarea sits plantar to the foot and rising upwardly from the invention, tointerface with the plantar aspect of the foot, and wherein; said raisedarea has a highest portion taking the form of a generally triangularplateau positioned in the region of the planter aspect of the anteriormost portion of the medial tubercle of the talus, the navicular, the1^(st) cuneiform and the medial most aspect of the cuboid and wherein;said raised area has outwardly directing surfaces tapering downwardlyand outwardly from the triangular plateau in all directions so as toterminate as they merge with the top layer of the invention and saidsurfaces extend medially such that they do not extend past a boundarydefined by the position of the medial most aspect of the navicular, andextend in the anterior direction such that they do not extend past thedistal two-thirds of the 2^(nd) metatarsal, and extend laterally suchthat they do not extend past the lateral most aspect of the cuboid, andextend in the posterior direction such that they do not extend past themedial tubercle of the calcaneus, and wherein: said raised area has anoticeable non-symmetric elongation of its posterior and medial regionextending rearward and downward from said triangular plateau. Saidelongation rises in an posterior-to-anterior and lateral-to-medialdirection so as to create a region of gradually increasing densityrelative to the corresponding region on the lateral aspect of saiddevice, in the region of the lateral tubercle of the calcaneus, in sucha manner as to introduce an inclined plane or wedge effect to the medialand anterior aspect of the calcaneus for the purpose of reducing theeversion of the calcaneus during the weight bearing phase of gait whichis characteristic of excess pronation and; 16) A Device as disclosed inclaim 15 wherein: said raised area has two or more openings designed toreceive inserts and the openings are arranged such that the medial mostopening and corresponding insert is positioned plantar to the foot andin the region of the posterior most aspect of the 1^(st) metatarsal, thenavicular, and the anterior most aspect of the talus and the lateralmost opening and corresponding insert is positioned plantar to the footand in the region of the lateral portion of the navicular interfacing inthe region of the muscle belly of the digitorum brevis and the flexorhallicus longus muscles, and; said inserts to be applied to saidopenings are of varying compressive properties enabling varyingdeflection and support to the medial and lateral aspects of saidtriangular plateau. 17) A device as disclosed in claim 15 wherein; saidtriangular plateau has it's longest side positioned to be align ablewith the medial most aspect of the foot, plantar to the region of themedial arch and running parallel with the long axis of the 1^(st)metatarsal and wherein; the triangular plateau has its vertex positionedin the region of the medial aspect of the navicular and not extendinglaterally past the lateral most aspect of the 2nd metatarsal. 18) Adevice as disclosed in claim 15 wherein; said triangular plateau sits ata height which is not less than 2.5% of the total foot length and notgreater than 7.5% of the total foot. 19) A device as disclosed in claim13 wherein; said raised area has a characteristic ridge extending fromthe triangular plateau forward in the anterior direction, align able andparallel to the 2^(nd) metatarsal of the foot and aligned such that saidridge does not deviate in the medial or lateral direction more than 12degrees from the centerline of the 2^(nd) metatarsal. 20) A device asdisclosed in claim 15 wherein; said raised area has noticeableaccommodation areas in the regions posterior to the sesamoids and thehead of the first metatarsal on the medial boundary of the foot, and theregion posterior of the fifth metatarsal head on the lateral boundary ofthe foot. Said medial accommodation areas and said lateral accommodationarea are positioned such that on a horizontal plane they lay inferior tothe balance of the raised area of the insole or midsole surface engagingthe plantar aspect of the foot.